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Individual

DR. JUSTIN RYAN HERCEG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
3570 EXECUTIVE DR, SUITE 211, UNIONTOWN, OH 44685-8712
(330) 563-4383
(330) 563-4874
Mailing address
3570 EXECUTIVE DR, GREEN, OH 44685-6713
(330) 563-4383
(330) 563-4874

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4108
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0078436
OH
01
1457691834
GROUP NPI
OH
01
1578872826
PERSONAL NPI
OH
01
H198420
GROUP PTAN
OH
01
H198421
INDIVIUAL PTAN
OH
Enumeration date
10/05/2010
Last updated
04/13/2026
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